BACKGROUND The growth of the private health insurance sector in Western countries, which is characterized by information deficiencies and limited competition, necessitates the implementation of effective regulatory tools. One measure which is widely used is the medical loss ratio (MLR). Our objective was to analyze how MLR is applied as a regulatory measure in the Israeli voluntary health insur...

Three studies (1,3,5) followed the tendon and nerve gliding exercise protocol described by Totten and Hunter (6), one study utilized only the nerve gliding exercises (4), and another study utilized modifications of the tendon gliding exercises (2). Patients with severe thenar atrophy were excluded in all cases, though only two studies specifically stated inclusion criteria of intermediate stage...

BACKGROUND Manual hyperinflation (MHI) and ventilator hyperinflation (VHI) are two methods of recruitment maneuvers used in ventilated patients to improve lung compliance and secretion mobilization. The use of VHI may minimize the adverse effects of disconnection from the ventilator, but it is uncertain whether high levels of positive end-expiratory pressure (PEEP) would decrease the peak expir...

OBJECTIVES To validate questionnaires on voice, speech, and swallowing among laryngeal cancer patients, to assess the need for and use of rehabilitation services, and to determine the association between voice, speech, and swallowing problems, and quality of life and distress. MATERIALS AND METHODS Laryngeal cancer patients at least three months post-treatment completed the VHI (voice), SHI (...

The aim of the current study was to evaluate the clinical effectiveness of voice training on patients with vocal cord polyps after phonomicrosurgery. The experimental group included 55 patients with vocal cord polyps after phonomicrosurgery that underwent voice training. Laryngostroboscopy, Voice Handicap Index (VHI), and Dysphonia Severity Index (DSI) were applied to evaluate patient voice qua...

PURPOSE To validate the Voice Handicap Index-10 (VHI-10) into Brazilian Portuguese and to check its psychometric measures. METHODS The validation was performed following the guidelines suggested by the Scientific Advisory Committee of the Medical Outcomes Trust. A hundred ten individuals participated, 60 with vocal complaint, 6 males and 54 females, with age ranging from 21 to 82 years; and 5...

We investigate whether people enrolled into voluntary health insurance (VHI) substitute public consumption with private (opt out) or just enlarge their private consumption, without reducing reliance upon public provisions (top up). We study the case of Italy, where a mixed insurance system is in place. To this purpose, we specify a joint model for public and private specialist visits counts, an...

BACKGROUND Although voice tremor is one of the most commonly noted clinical features of essential tremor (ET), there are nearly no published data on the handicap associated with it. METHODS The Voice Handicap Index (VHI) was self-administered by participants enrolled in a research study at Columbia University Medical Center. The VHI quantifies patients' perceptions of handicap due to voice di...

UNLABELLED Voice and speech are regulated by hearing. Vocal disorders in patients with hearing loss have not been evaluated yet as to the subjective degree of disability they cause in this group. AIM to compare the results of the Voice Handicap Index (VHI) obtained for patients with normal hearing and moderate to profound bilateral sensorineural hearing loss. STUDY DESIGN Controlled, cross-...

BACKGROUND Symptoms from throat (sensation of globus; frequent throat clearing; irritated throat) are common in patients referred to voice clinics and to ENT specialists. The relation to symptoms of voice discomfort is unclear and in some cases patients do not have voice problems at all. Instruments for patients' self-reporting of symptoms, and assessment of handicap, such as the Voice Handicap...